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Individual

MRS. BRENDA ANNE STEPHENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, APRN, FNP-BC

Contact information

Practice address
800 HOSPITAL DR, MADISONVILLE, KY 42431-1658
(270) 326-3800
Mailing address
200 CLINIC DR, MADISONVILLE, KY 42431-1661

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3002928
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000371551
BCBS PROVIDER NUMBER
01
000000577781
ANTHEM BC & BS
KY
01
000000819232
BCBS BAPTIST HEALTH MADISONVILLE
KY
05
78005196
KY
Enumeration date
09/17/2006
Last updated
01/08/2015
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